Shiqi Guo1,2, Qiang Guo3,4,5. 1. Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. 2. Department of Emergency, Suzhou Dushuhu Public Hospital (Dushuhu Public Hospital Affiliated to Soochow University), No.9 Chongwen Road, Suzhou Industrial Park, Suzhou, 215000, Jiangsu, China. 3. Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. guojiang@suda.edu.cn. 4. Department of Emergency, Suzhou Dushuhu Public Hospital (Dushuhu Public Hospital Affiliated to Soochow University), No.9 Chongwen Road, Suzhou Industrial Park, Suzhou, 215000, Jiangsu, China. guojiang@suda.edu.cn. 5. Department of Pulmonary and Critical Care Medicine, Suzhou Dushuhu Public Hospital (Dushuhu Public Hospital Affiliated to Soochow University), Suzhou, Jiangsu, China. guojiang@suda.edu.cn.
Abstract
BACKGROUND: Septic cardiomyopathy has been observed in association with influenza, indicating that not only bacteria but also other infective agents can cause this condition. There has been no systematic study as to whether Treponema pallidum infection induces septic cardiomyopathy, and we are the first to report this possibility. CASE PRESENTATION: We report two cases of a 48-year-old man and a 57-year-old man who were diagnosed with syphilis-related septic cardiomyopathy. The diagnosis of cardiomyopathy was made based on elevation of cardiogenic markers and decrease in ejection fraction evaluated by echocardiography. Screen for infective pathogens was negative except for syphilis, which supported our diagnosis. The two patients recovered following effective anti-syphilis treatment and advanced life support technology. Syphilis serology became negative after treatment. CONCLUSION: Syphilis has the potential to cause septic cardiomyopathy. Clinicians should consider Treponema pallidum in cases of septic cardiomyopathy with unknown pathogens. However, the specific pathophysiological mechanism of syphilis-associated septic cardiomyopathy has not been elucidated, and more specific studies are needed.
BACKGROUND:Septic cardiomyopathy has been observed in association with influenza, indicating that not only bacteria but also other infective agents can cause this condition. There has been no systematic study as to whether Treponema pallidum infection induces septic cardiomyopathy, and we are the first to report this possibility. CASE PRESENTATION: We report two cases of a 48-year-old man and a 57-year-old man who were diagnosed with syphilis-related septic cardiomyopathy. The diagnosis of cardiomyopathy was made based on elevation of cardiogenic markers and decrease in ejection fraction evaluated by echocardiography. Screen for infective pathogens was negative except for syphilis, which supported our diagnosis. The two patients recovered following effective anti-syphilis treatment and advanced life support technology. Syphilis serology became negative after treatment. CONCLUSION: Syphilis has the potential to cause septic cardiomyopathy. Clinicians should consider Treponema pallidum in cases of septic cardiomyopathy with unknown pathogens. However, the specific pathophysiological mechanism of syphilis-associated septic cardiomyopathy has not been elucidated, and more specific studies are needed.
Entities:
Keywords:
Case report; Sepsis-induced cardiomyopathy; Septic cardiomyopathy; Syphilis; Treponema pallidum
Authors: Sarah J Beesley; Gerhard Weber; Todd Sarge; Sara Nikravan; Colin K Grissom; Michael J Lanspa; Sajid Shahul; Samuel M Brown Journal: Crit Care Med Date: 2018-04 Impact factor: 7.598